Retrograde dissection of the temporalis muscle preventing muscle atrophy for pterional craniotomy

1996 ◽  
Vol 84 (2) ◽  
pp. 297-299 ◽  
Author(s):  
Susumu Oikawa ◽  
Masahiko Mizuno ◽  
Shinsuke Muraoka ◽  
Shigeaki Kobayashi
Keyword(s):  
Muscle Atrophy ◽  
Simple Technique ◽  
Temporalis Muscle ◽  
Content Type ◽  
Pterional Craniotomy ◽  
Less Invasive ◽  
Fine Print

✓ A procedure for preventing muscle atrophy in pterional craniotomy by temporalis muscle dissection is described, along with anatomical considerations. The inferior to superior dissection of the temporalis muscle is a very simple technique and is less invasive than other approaches.

Preservation of the frontotemporal branch of the facial nerve using the interfascial temporalis flap for pterional craniotomy

1987 ◽  
Vol 67 (3) ◽  
pp. 463-466 ◽  
Author(s):  
M. Gazi Yaşargil ◽  
Mark V. Reichman ◽  
Stefan Kubik
Keyword(s):  
Facial Nerve ◽  
Temporalis Muscle ◽  
Content Type ◽  
Pterional Craniotomy ◽  
Fine Print

✓ The pterional craniotomy as described previously by the first author requires creation of a special flap over the temporalis muscle for increased visibility. Topographical variations of the course taken by the frontal branches of the facial nerve were studied and are described in this report.

Reconstruction of the temporalis muscle for the pterional craniotomy

1990 ◽  
Vol 73 (4) ◽  
pp. 636-637 ◽  
Author(s):  
Robert F. Spetzler ◽  
K. Stuart Lee
Keyword(s):  
Bone Flap ◽  
Temporalis Muscle ◽  
Content Type ◽  
Pterional Craniotomy ◽  
Fine Print

✓ Several techniques have been employed to incise the temporalis muscle for the pterional craniotomy. The authors describe a method which provides the advantage of a free bone flap, yet allows anatomical reapproximation of the temporalis muscle to its bone attachment.

Modified osteoplastic orbitozygomatic craniotomy

2005 ◽  
Vol 102 (5) ◽  
pp. 940-944 ◽  
Author(s):  
Vijayabalan Balasingam ◽  
Akio Noguchi ◽  
Sean O. McMenomey ◽  
Johnny B. Delashaw
Keyword(s):  
Surgical Technique ◽  
Muscle Atrophy ◽  
Bone Infection ◽  
Bone Flap ◽  
Temporalis Muscle ◽  
Content Type ◽  
Orbital Rim ◽  
Supraorbital Foramen ◽  
Fine Print

✓ The authors report on a surgical technique involving a one-piece osteoplastic bone flap, which incorporates the frontal, temporal, and lateral portions of the orbital rim as a technically simpler alternative to the standard orbitozygomatic (OZ) craniotomy. The orbital rim component extends just laterally from the supraorbital foramen/notch to the frontozygomatic suture. This craniotomy obviates the need for removing the zygoma and has evolved from the authors' experience in more than 200 patients with a variety of pathological lesions, both vascular and tumorous. The osteoplastic aspect of this technique was initially evaluated in 14 cadaveric sites in seven heads dissected prior to implementing this procedure clinically. The osteoplastic bone flap minimally obstructs the surgical view and provides all the advantages of a standard OZ craniotomy. Temporalis muscle atrophy leading to temporal hollowing is avoided, a bone union to the calvaria is improved, and the possibility of bone infection is decreased. The osteoplastic component of the technique adds to the improved long-term cosmesis and warrants active consideration in the art of neurosurgery.

Alternative to tarsorrhaphy in peripheral facial nerve palsy with expectation of functional recovery

1984 ◽  
Vol 61 (2) ◽  
pp. 405-406 ◽  
Author(s):  
Eduardo Fernandez ◽  
Roberto Pallini ◽  
Giulio Maira
Keyword(s):  
Facial Nerve ◽  
Functional Recovery ◽  
Nerve Palsy ◽  
Simple Technique ◽  
Facial Nerve Palsy ◽  
Nerve Function ◽  
Content Type ◽  
Peripheral Facial Nerve Palsy ◽  
Opening And Closing ◽  
Fine Print

✓ A simple technique is described for protecting the cornea in patients with peripheral facial nerve palsy while waiting for recovery of nerve function. The application of an adhesive strip to the superior eyelid permits opening and closing of the eye, and provides good protection of the cornea.

scholarly journals Interdigitated craniotomy: a simple technique to fix a bone flap with only a single plate

2015 ◽  
Vol 123 (4) ◽  
pp. 1055-1058 ◽  
Author(s):  
Noboru Takahashi ◽  
Kazunori Fujiwara ◽  
Keiichi Saito ◽  
Teiji Tominaga
Keyword(s):  
Simple Technique ◽  
Plate Fixation ◽  
Bone Flap ◽  
Cranial Bone ◽  
Temporalis Muscle ◽  
Cosmetic Results ◽  
Pterional Craniotomy ◽  
Single Plate ◽  
Radiological Images ◽  
Cut Surface

In pterional craniotomy, fixation plates cause artifacts on postoperative radiological images; furthermore, they often disfigure the scalp in hairless areas. The authors describe a simple technique to fix a cranial bone flap with only a single plate underneath the temporalis muscle in an area with hair, rather than using a plate in a hairless area. The key to this technique is to cut the anterior site of the bone flap at alternate angles on the cut surface. Interdigitation between the bone flap and skull enables single-plate fixation in the area with hair, which reduces artifacts on postoperative radiological images and provides excellent postoperative cosmetic results.

Treatment of postoperative subgaleal cerebrospinal fluid fistulas by using fibrin sealant

1999 ◽  
Vol 90 (6) ◽  
pp. 1143-1145 ◽  
Author(s):  
Tomas Menovsky ◽  
Joost de Vries ◽  
Heinz-Georg Bloss
Keyword(s):  
Cerebrospinal Fluid ◽  
Fibrin Sealant ◽  
Simple Technique ◽  
Cerebrospinal Fluid Fistula ◽  
Content Type ◽  
Fluid Fistula ◽  
Fine Print

✓ The authors describe a simple technique by which a postoperative subgaleal cerebrospinal fluid fistula is treated by local tapping and injection of fibrin sealant through the same needle.

Clip wrapping for partial avulsion of the aneurysm neck

2003 ◽  
Vol 99 (5) ◽  
pp. 931-932 ◽  
Author(s):  
Giuseppe Lanzino ◽  
Robert F. Spetzler
Keyword(s):  
Simple Technique ◽  
Aneurysm Rupture ◽  
Content Type ◽  
Aneurysm Neck ◽  
Fine Print

✓ An intraoperative aneurysm rupture due to a tear at the aneurysm neck can be a tricky complication to manage. The authors describe a simple technique found to be useful in such a case.

Pterional craniotomy via a transcavernous approach for the treatment of low-lying distal basilar artery aneurysms

1998 ◽  
Vol 89 (6) ◽  
pp. 921-926 ◽  
Author(s):  
Stephen L. Nutik
Keyword(s):  
Cavernous Sinus ◽  
Basilar Artery ◽  
Anterior Clinoid Process ◽  
Technical Problems ◽  
Content Type ◽  
Pterional Craniotomy ◽  
Transsylvian Approach ◽  
Posterior Clinoid Process ◽  
Additional Exposure ◽  
Fine Print

Object. The author describes a surgical procedure in which pterional craniotomy is performed via a transcavernous approach to treat low-lying distal basilar artery (BA) aneurysms. This intradural procedure is compared with the extradural procedure described by Dolenc, et al. Methods. The addition of a transcavernous exposure to the standard pterional intradural transsylvian approach allows a lower exposure of the distal BA behind the dorsum sellae. The technical steps involved in this procedure are as follows: 1) removal of the anterior clinoid process: 2) entry into the cavernous sinus medial to the third nerve; 3) packing of the venous channels of the cavernous sinus lying between the carotid artery and the pituitary gland to open this space; 4) removal of the posterior clinoid process and the portion of the dorsum sellae that is exposed from within the cavernous sinus; and 5) removal of the exposed dura mater to obtain additional exposure of the perimesencephalic cistern. Eight cases of aneurysms of the distal BA are presented to illustrate how this approach can help in their surgical treatment. Conclusions. Using the standard pterional approach, these distal BA aneurysms were found to be either too low relative to the posterior clinoid process for adequate exposure or there was insufficient room for temporary clipping of the BA proximal to the lesion. The addition of a transcavernous exposure eliminated these technical problems and aneurysm clipping could be accomplished in each case.

Vascularized temporalis muscle flap for the treatment of otorrhea

2003 ◽  
Vol 98 (5) ◽  
pp. 1128-1132 ◽  
Author(s):  
Gabriel C. Tender ◽  
Scott Kutz ◽  
Deepak Awasthi ◽  
Peter Rigby
Keyword(s):  
Intracranial Pressure ◽  
Muscle Flap ◽  
Middle Fossa ◽  
Temporalis Muscle ◽  
Increased Intracranial Pressure ◽  
Content Type ◽  
Middle Fossa Approach ◽  
Medial Side ◽  
Temporalis Muscle Flap ◽  
Fine Print

✓ The surgical treatment for cerebral spinal fluid (CSF) fistulas provides closure of the bone and dural defects and prevents the recurrence of brain herniation and CSF fistula. The two main approaches used are the transmastoid and middle fossa ones. The authors review the results of performing a modified middle fossa approach with a vascularized temporalis muscle flap to create a barrier between the repaired dural and bone defects. Fifteen consecutive cases of CSF fistulas treated at the authors' institution were retrospectively reviewed. All patients presented with otorrhea. Eleven patients had previously undergone ear surgery. A middle fossa approach was followed in all cases. The authors used a thin but watertight and vascularly preserved temporalis muscle flap that had been dissected from the medial side of the temporalis muscle and was laid intracranially on the floor of the middle fossa, between the repaired dura mater and petrous bone. The median follow-up period was 2.5 years. None of the patients experienced recurrence of otorrhea or meningitis. There was no complication related to the intracranial temporalis muscle flap (for example, seizures or increased intracranial pressure caused by muscle swelling). One patient developed hydrocephalus, which resolved after the placement of a ventriculoperitoneal shunt 2 months later. The thin, vascularized muscle flap created an excellent barrier against the recurrence of CSF fistulas and also avoided the risk of increased intracranial pressure caused by muscle swelling. This technique is particularly useful in refractory cases.

Retrieval of broken pedicle screws by “friction” technique

2000 ◽  
Vol 92 (1) ◽  
pp. 114-116 ◽  
Author(s):  
Nicola Di Lorenzo ◽  
Renato Conti ◽  
Stefano Romoli
Keyword(s):  
Simple Technique ◽  
Pedicle Screws ◽  
Slow Speed ◽  
Technical Application ◽  
Content Type ◽  
Screw Hole ◽  
Inner Surface ◽  
Stainless Steel Screws ◽  
Cut Surface ◽  
Fine Print

U The authors describe a simple and fast technique for removal of deeply situated broken pedicle screw fragments. The screw fragments are removed using a fine-serrated, conically cored bit with a light rough inner surface that is mounted on a common slow-speed drill capable of rotating clockwise and counterclockwise. The cored head of the bit is pressed and engaged on the cut surface of the broken screw, and the drill is made to turn in counterclockwise rotation; this, by means of friction, causes the two surfaces to interlock, and consequently the broken screw fragment backs out. This technique was used to retrieve both broken titanium and stainless steel screws, and satisfying results were obtained. There were no complications associated with the application of the technique, and the pedicle as well as the screw hole were always preserved, offering, in the event that the vertebral instability continued, the possibility of applying a new screw of slightly larger diameter at the same screw hole. This technical application offers the opportunity of removing deeply situated screw fragments by using a simple technique while maintaining the vertebral pedicle and screw-hole integrity.

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